Intraoperative applied research on axial and frontal X-ray radiography techniques of sustentaculum tali in the treatment of intra-articular calcaneal fractures
Wang Bing1, Shi Ce1, Yang Chun1, Qiao Fenglei2, Zhu Aixiang1, Zhou Jingjing2, Dong Zhen1, Zhu Yucheng1, Ma Jun1
1Department of Orthopaedics, the Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, China; 2Department of Medical Imaging, the Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, China
Abstract：Objective This study aimed to investigate the intraoperative clinical application valume of the axial and frontal X-ray radiography techniques of the sustentaculum tali in the treatment of intra-articular calcaneal fractures. Methods From January 2015 to January 2020, in the Affiliated Suqian Hospital of Xuzhou Medical University, the clinical data of 82 patients (92 feet) with Sanders typeⅡ–Ⅳ intra-articular calcaneal fractures treated by using internal fixation of plates/screws were analyzed retrospectively. The patients comprised 47 males and 35 females, with ages ranging from 18 years to 71 years. On the basis of the different methods of intraoperative fluoroscopy, they were assigned into a routine group and an observation group. The routine group included 45 patients (25 males and 20 females with an average age of 39.65 years±9.28 years) with 50 feet by a lateral and axial X-ray fluoroscopy of calcaneus during the operation. The observation group included 37 patients (22 men and 15 women with an average age of 41.22 years±8.65 years)with 42 feet. Besides lateral X-ray fluoroscopy of calcaneus, axial and frontal X-ray fluoroscopy of the sustentaculum tali were also conducted. After the operation, multislice spiral computed tomography scanning and Mimics modeling of the ankle and foot were performed to evaluate the quality of screw placement into the sustentaculum tali. Between the routine group and observation group, the differences of the total number per group,the average number per foot, and their rate of screw placement were compared and analyzed. Results No significant differences in the preoperative general data were found between the two groups(all P values＞0.05). Sixty screws were placed into the sustentaculum tali for 50 feet with an average screw placement for each foot (1.22±0.43) in the routine group. In the observation group, 67 screws were placed into the sustentaculum tali for 42 feet with an average for each foot (1.61±0.53); the difference was statistically significant (t=4.521, P＜0.05). Compared with the routine group, the observation group had a higher excellent rate of screw placement into the sustentaculum tali (97.01% [65/67] vs. 85.00% [51/60]), showing a statistical difference (χ2=5.776, P＜0.05). Conclusions On the basis of lateral X-ray fluoroscopy of calcaneus, the application of the axial and frontal fluoroscopy of sustentaculum tali to aid intraoperative X-ray fluoroscopy of intra-articular calcaneal fractures to guide the screw placement is helpful to increase the number of screw placed,improve the accuracy of the screw placement.
王冰, 史册, 杨春, 乔风雷, 朱爱祥, 周晶晶, 董真, 朱裕成, 马军. 载距突轴位和正位X线成像技术在跟骨关节内骨折手术中的应用价值[J]. 中华解剖与临床杂志, 2021, 26(2): 125-131.
Wang Bing, Shi Ce, Yang Chun, Qiao Fenglei, Zhu Aixiang, Zhou Jingjing, Dong Zhen, Zhu Yucheng, Ma Jun. Intraoperative applied research on axial and frontal X-ray radiography techniques of sustentaculum tali in the treatment of intra-articular calcaneal fractures. Chinese Journal of Anatomy and Clinics, 2021, 26(2): 125-131.
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2021, Vol. 26 
